What is TB?

Tuberculosis is an infectious disease contracted by inhalation, which often attacks different parts of the body, commonly the neck glands and the lungs. It is characterized by fatigue, coughing and weight loss. Tuberculosis is a complicated disease that is very difficult to treat effectively and can recur under certain conditions. From the late nineteenth century to the first half of the twentieth century tuberculosis became a major public health concern in Canada and elsewhere, and many more First Nations, Inuit and Métis people than non-Aboriginal people had active, serious and deadly cases of the disease. This led to the widespread assumption that people of Indigenous ancestry were racially susceptible to the disease. Rather, dislocation, poverty, malnutrition, overcrowding and inadequate housing contributed to its high incidence, and these were conditions experienced by large segments of the First Nations and Métis populations in Manitoba. These circumstances are directly influenced by the conditions of colonization including repressive economic, political, cultural and social policies, military invasions, dispossession and white settlement and the loss of resources from the land, including the bison.

Until 1940, very few resources were committed to providing services for First Nations people with tuberculosis. The federal government, which is responsible for First Nations health, largely ignored the issue, while provincial and municipal sanatoria and other hospitals in the West did not tend to admit Indigenous people for treatment for a number of reasons. But in the 1930s, medical professionals increasingly warned of the “menace” people of Indigenous ancestry with tuberculosis posed to public health in the province. The Sanatorium Board of Manitoba, a voluntary organization, committed to a relationship with the federal Indian Health Service to manage a segregated program of surveying, institutionalization and rehabilitation for First Nations people and some Métis people in Manitoba and north-western Ontario and Inuit from parts of the Central Arctic. Between 1940 and 1965, thousands of Indigenous people were treated for tuberculosis in three sanatoria in Manitoba dedicated primarily to the treatment of “Indian TB,” Dynevor Indian Hospital, Clearwater Lake Indian Hospital and Brandon Sanatorium. Conditions at these hospitals was often substandard. They were variously drafty in winter, hot in summer, poorly insulated and heated, damp and infested with vermin, inadequately wired, and understaffed.  Other Indigenous people were treated elsewhere including Ninette, St. Boniface Hospital, King Edward Hospital and the Central TB Clinic.

If you read a newspaper in Manitoba in the 1930s and 1940s and only learned one thing about Native people, it would be that they were sick and dying of tuberculosis. If you learned a second thing, it was that the Sanatorium Board of Manitoba and the federal government were doing stellar work in addressing the problem. According to a survey of over five hundred Manitoba newspaper articles conducted as part of this project, we found that newspaper articles were consistently celebratory of the work of the Sanatorium Board and the government of Canada in their ways of dealing with tuberculosis among Indigenous people. However there was change over time in the way stories about tuberculosis unfolded in the media. In the 1930s, an individual’s “risk” of contracting TB was understood as a matter of the presence or absence of Indian blood and proximity to Indian people whereas by the 1960s, living conditions, rather than biology were increasingly blamed for higher rates of TB among First Nations people. In the 1940s, media attention shifted to the development of medical facilities for treaty Indians including Dynevor and Fisher River hospitals and the launching of TB control plans including x-ray surveys. Such articles assured the public that the ‘threat’ of Indian TB was being managed and that control was within reach. Pride about this action swelled as TB rates declined in the 1950s and 1960s, and yet the focus remained on ‘Indian’ and increasingly Inuit ill health, and papers warned against “TB Complacency.”

While rates of tuberculosis dropped dramatically in Canada after the 1960s, especially with the increasing use of antibiotics, the disease has never been fully eradicated. Moreover, infection rates remain considerably higher within Indigenous populations than within the non-Indigenous Canadian population. For a recent government report on tuberculosis in Canada that addresses both historical and present dimensions of the disease, click hereFor a general overview of tuberculosis published in the Canadian Encyclopedia, click here.